Lateral epicondylitis — SCE Rheumatology MCQ

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EasyOsteoarthritis and soft tissue rheumatologyLateral epicondylitisSCE Rheumatology

A 46-year-old man develops pain over the lateral aspect of his elbow after several weeks of repetitive gripping at work. There is maximal tenderness directly over the lateral epicondyle, and resisted wrist extension reproduces his pain. Elbow movement is full, with no joint or bursal swelling. What is the most likely diagnosis?

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Correct answer: B — Lateral epicondylitis

The diagnosis is lateral epicondylitis (lateral elbow tendinopathy). The discriminating findings are pain and maximal tenderness directly over the lateral epicondyle following repetitive gripping, with symptom reproduction on resisted wrist extension. Radial tunnel syndrome generally causes tenderness further distally over the radial tunnel and is more characteristically provoked by resisted supination or middle-finger extension. Gout and inflammatory arthritis would usually produce joint inflammation, such as swelling, warmth, restriction or synovitis. Olecranon bursitis causes focal posterior swelling over the olecranon rather than lateral epicondylar pain. Lateral epicondylitis is principally a clinical diagnosis, and routine imaging is unnecessary when the presentation is typical.

Reference: Hertfordshire and West Essex ICB. Elbow Pain—Epicondylitis Medial/Lateral pathway. 2026. https://www.hweclinicalguidance.nhs.uk/all-clinical-areas-documents/download?checksum=3241ddf4288826c398226b93f411120a&cid=1625&document=22&field=1